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Common Questions

Common Questions

About OFF periods

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What is an OFF period?
The return of symptoms between regular doses of Parkinson’s medication are called OFF periods or OFF episodes. If you notice your symptoms returning before it’s time for your next medication dose, you could be experiencing an OFF period. It’s important to let your doctor know if you think you might be having OFF periods.
Does everyone with Parkinson’s have OFF periods?

About 40% of the approximately 1 million people in the US living with Parkinson's will experience OFF periods.

In an online survey of more than 3,000 people with Parkinson’s conducted by the Michael J. Fox Foundation, nearly 70% of participants said they experienced at least 2 OFF periods a day.

About INBRIJATM

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What is INBRIJA?
INBRIJA is a prescription medicine that is specifically formulated levodopa for oral inhalation (through the mouth). It is used to treat OFF periods in adults with Parkinson’s on carbidopa/levodopa in addition to their regular medication. INBRIJA does not replace your regular carbidopa/levodopa medicine.
What are the most common side effects of INBRIJA?
The most common side effects of INBRIJA are cough, upper respiratory tract infection, nausea, and change in the color of saliva or spit.
Why doesn’t INBRIJA replace my other Parkinson’s medications?
INBRIJA is orally inhaled levodopa used as needed to treat the return of your Parkinson’s symptoms and is used as an add‑on therapy only, which means it does not replace your usual carbidopa/levodopa regimen. INBRIJA has not been studied in patients not taking their regular carbidopa/levodopa medicine and will not work without it.
Are there reasons why I can't take INBRIJA?

If you take, or within the last 2 weeks you have taken, a nonselective monoamine oxidase inhibitor such as phenelzine or tranylcypromine, do not use INBRIJA. Your blood pressure may increase.

Before using INBRIJA, tell your healthcare provider if you have asthma, chronic obstructive pulmonary disease (COPD), or any chronic lung disease.

Tell your healthcare provider if you experience bronchospasm. People with asthma, COPD, or other lung diseases may wheeze or have difficulty breathing after inhaling INBRIJA. If this occurs, stop taking INBRIJA and seek immediate medical attention.

Before using INBRIJA, tell your healthcare provider about any other medical conditions, including:

  • daytime sleepiness, sleep disorders, sleepiness/drowsiness without warning, or use of medicine that increases sleepiness, including antidepressants or antipsychotics
  • dizziness, nausea, sweating, or fainting when standing up
  • abnormal movement (dyskinesia)
  • mental health problems such as hallucinations or psychosis
  • uncontrollable urges like gambling, sexual urges, spending money, or binge eating
  • glaucoma
  • pregnancy or plans to become pregnant. It is unknown if INBRIJA will harm an unborn baby.
  • breastfeeding or plans to breastfeed. Levodopa can pass into breastmilk and it is unknown if it can harm the baby

Talking With Your Doctor

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What should I tell my doctor before taking INBRIJA?

Give your doctor as many details as possible about any symptoms you experience between doses of your regular Parkinson’s medication. It may be helpful to keep a journal that notes when you have symptoms, what they are, the time of day, and how long they last. Speaking Up About OFF Periods, our doctor discussion guide, includes a symptom checklist and can help you prepare for discussions with your doctor.

Before using INBRIJA, tell your healthcare provider about your medical conditions, including:

  • asthma, chronic obstructive pulmonary disease (COPD), or any chronic lung disease
  • daytime sleepiness, sleep disorders, sleepiness/drowsiness without warning, or use of medicine that increases sleepiness, including antidepressants or antipsychotics
  • dizziness, nausea, sweating, or fainting when standing up
  • abnormal movement (dyskinesia)
  • mental health problems such as hallucinations or psychosis
  • uncontrollable urges like gambling, sexual urges, spending money, or binge eating
  • glaucoma
  • pregnancy or plans to become pregnant. It is unknown if INBRIJA will harm an unborn baby.
  • breastfeeding or plans to breastfeed. Levodopa can pass into breastmilk and it is unknown if it can harm the baby

Using INBRIJA

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Will I be able to use INBRIJA while I’m experiencing an OFF period?

Most people in clinical trials were able to use INBRIJA. In fact, 99.8% (628 out of 629) of people with Parkinson’s who participated in two clinical studies were able to use INBRIJA in an OFF period after receiving instruction.

Remember to take an INBRIJA dose as soon as you feel Parkinson’s symptoms start to return.

When should I take INBRIJA?

Use INBRIJA exactly as prescribed. INBRIJA should be taken when symptoms of an OFF period start to return. INBRIJA does not replace your regular carbidopa/levodopa medicine.

Use INBRIJA as needed (2 capsules per dose, no more than 5 doses a day) when your Parkinson’s symptoms start to return. Do not use more than 1 dose (2 capsules) per OFF period.

How do I use the INBRIJA inhaler?
Get step by step instructions for using your INBRIJA inhaler here. You can also download the Instructions For Use.
Why is one dose in two capsules?
A full dose of INBRIJA does not fit inside a single capsule, and so a complete dose is 2 capsules.
Why can’t I swallow the capsules instead of using the inhaler?
INBRIJA capsules must not be swallowed or opened as the intended effect will not be obtained. INBRIJA capsules are only for oral inhalation use (through the mouth) and are only for use with the INBRIJA inhaler. Don’t use the INBRIJA inhaler to take any other medicine.
Why can’t I load both capsules at the same time?
The inhaler is designed to hold only 1 INBRIJA capsule at a time. Do not attempt to load 2 capsules at the same time.
How do I know that the capsule is loaded correctly and ready to inhale?

After you have loaded a capsule into the inhaler, line up the white arrows on the handle and mouthpiece and firmly push the mouthpiece and handle together until you hear a click. When you release the mouthpiece, it will spring back and stay attached. Make sure the mouthpiece is securely attached and won't fall off. The inhaler is now ready to use.

Do not push the handle and mouthpiece together more than once since this may damage the capsule and you may not get your full dose. If this happens, throw the capsule away and load a new capsule.

See the INBRIJA Instructions For Use for more information.

What if I don’t hear or feel the whirl when I am using the inhaler?
If you did not hear or feel the capsule whirl while inhaling you may need to take a deeper, longer breath. Breathe out, keep the inhaler level, close your lips firmly around the mouthpiece and inhale again (with a deep, comfortable breath) using the same capsule.
What should I do if I cough in the middle of taking INBRIJA?
In clinical trials, the most common side effect for INBRIJA was cough. Inhalation of INBRIJA can lead to coughing at the time of administration. If you cough, breathe out, keep the inhaler level, close your lips firmly around the mouthpiece and inhale again (with a deep comfortable breath) using the same capsule.
What can I do to help with cough when taking INBRIJA?
In clinical trials, the most common side effect for INBRIJA was cough. Inhalation of INBRIJA can lead to coughing at the time of administration. Sips of water may be taken in between inhaling the 2 capsules of INBRIJA, as needed for throat dryness.
Can I keep a capsule loaded in the inhaler ahead of time?
No, keep capsules inside their foil (blister) packages until ready to use. Never store a capsule inside the inhaler for a future dose.
How should I store INBRIJA?
Store the inhaler and capsules in a dry place at room temperature (68°F to 77°F [20°C to 25°C]). Do not freeze or refrigerate INBRIJA. Keep the inhaler and capsules dry and out of reach of children. Keep capsules inside their foil (blister) packages until just before you are ready to use them. Do not store capsules in the inhaler for a future dose. Throw out the inhaler after all capsules in the carton have been used. Use the new inhaler that comes with your prescription refill.
Why can’t I wash the inhaler?

The INBRIJA inhaler and capsules must be kept dry. It is normal for some powder to remain on the inhaler. Cleaning the inhaler isn't necessary, but if you would like to clean the inhaler, use a dry cotton swab or dry tissue to wipe the inside or outside of the mouthpiece.

How long can I keep using the same inhaler?
Use the new inhaler that comes with each prescription refill. Remember to throw out the inhaler after all capsules in a carton have been used.

Getting Support

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What support does Prescription Support Services provide?
Prescription Support Services specialists work with your doctor and specialty pharmacy to get you started on INBRIJA. They confirm your coverage and out‑of‑pocket expenses, and help to answer questions you may have about your coverage.
Whom can I contact if I have additional questions?
If you have additional questions about INBRIJA, feel free to call Prescription Support Services (1‑888‑887‑3447). Contact your doctor if you have questions about your medical care.
What if I can’t afford INBRIJA?

If you have commercial insurance (employer sponsored or individual) and INBRIJA is covered, you may be eligible for co-pay assistance for INBRIJA where allowed by law. Patients who participate in Medicaid, Medicare, or any other federal healthcare program are not eligible to receive co‑pay assistance.

If you do not have insurance and cannot afford INBRIJA, Prescription Support Services may be able to help. You may be eligible for the Patient Assistance Program which is designed to help you get INBRIJA at no cost. Ask us for more information about the program and how to apply.

If you are enrolled in Medicare and have limited financial resources, you may qualify for the Medicare Extra Help program to help pay for some healthcare and prescription drug costs. Ask us for details about how to apply for the program. The Medicare Extra Help program is a federal program, and is not managed by Acorda.

Have questions?

Contact us at 1‑833‑INBRIJA

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Indication

INBRIJA™ is a prescription medicine used when needed for OFF episodes in adults with Parkinson’s treated with regular carbidopa/levodopa medicine. INBRIJA does not replace regular carbidopa/levodopa medicine.

Important Safety Information

Do not use INBRIJA if you take or have taken a nonselective monoamine oxidase inhibitor such as phenelzine or tranylcypromine within the last 2 weeks.

Indication

INBRIJA is a prescription medicine used when needed for OFF episodes in adults with Parkinson’s treated with regular carbidopa/levodopa medicine. INBRIJA does not replace regular carbidopa/levodopa medicine.

Important Safety Information

Do not use INBRIJA if you take or have taken a nonselective monoamine oxidase inhibitor such as phenelzine or tranylcypromine within the last 2 weeks.

Before using INBRIJA, tell your healthcare provider about your medical conditions, including:

  • asthma, chronic obstructive pulmonary disease (COPD), or any chronic lung disease
  • daytime sleepiness, sleep disorders, sleepiness/drowsiness without warning, or use of medicine that increases sleepiness, including antidepressants or antipsychotics
  • dizziness, nausea, sweating, or fainting when standing up
  • abnormal movement (dyskinesia)
  • mental health problems such as hallucinations or psychosis
  • uncontrollable urges like gambling, sexual urges, spending money, or binge eating
  • glaucoma
  • pregnancy or plans to become pregnant. It is unknown if INBRIJA will harm an unborn baby.
  • breastfeeding or plans to breastfeed. Levodopa can pass into breastmilk and it is unknown if it can harm the baby.

Tell your healthcare provider if you take:

  • MAO-B inhibitors
  • dopamine (D2) antagonists (including phenothiazines, butyrophenones, risperidone, metoclopramide)
  • isoniazid
  • iron salts or multivitamins that contain iron salts

Do not drive, operate machinery, or do other activities until you know how INBRIJA affects you. Sleepiness and falling asleep suddenly can happen as late as a year after treatment is started.

Tell your healthcare provider if you experience the following side effects:

  • falling asleep during normal daily activities with or without warning. If you become drowsy, do not drive or do activities where you need to be alert. Chances of falling asleep during normal activities increases if you take medicine that cause sleepiness.
  • withdrawal-emergent hyperpyrexia and confusion (fever, stiff muscles, or changes in breathing and heartbeat) if you suddenly stop using INBRIJA or carbidopa/levodopa, or suddenly lower your dose of carbidopa/levodopa.
  • low blood pressure when standing up (that may be with dizziness, fainting, nausea, and sweating). Get up slowly after sitting/lying down.
  • hallucinations and other psychosis – INBRIJA may cause or worsen seeing/hearing/believing things that are not real; confusion, disorientation, or disorganized thinking; trouble sleeping; dreaming a lot; being overly suspicious or feeling people want to harm you; acting aggressive; and feeling agitated/restless.
  • unusual uncontrollable urges such as gambling, binge eating, shopping, and sexual urges has occurred in some people using medicine like INBRIJA.
  • uncontrolled, sudden body movements (dyskinesia) may be caused or worsened by INBRIJA. INBRIJA may need to be stopped or other Parkinson’s medicines may need to be changed.
  • bronchospasm – people with asthma, COPD, or other lung diseases may wheeze or have difficulty breathing after inhaling INBRIJA. If this occurs, stop taking INBRIJA and seek immediate medical attention.
  • increased eye pressure in patients with glaucoma. Your healthcare provider should monitor this.
  • changes in certain lab values including liver tests

The most common side effects of INBRIJA are cough, upper respiratory tract infection, nausea, and change in the color of saliva or spit.

Do not orally inhale more than 1 dose (2 capsules) for any OFF period. Do not take more than 5 doses (10 capsules) in a day.

Please see the Patient Information Leaflet.